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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Warrant to Purchase Common Stock (Right to buy) | $ 2.9 | 10/17/2011 | A(10) | 257,544 (11) | (10) | (10) | Common Stock | 257,544 | (10) | 257,544 (11) | D | ||||
Warrant to Purchase Common Stock (Right to buy) | $ 2.9 | 10/17/2011 | A(10) | 9,568 (12) | (10) | (10) | Common Stock | 9,568 | (10) | 9,568 (12) | D | ||||
Warrant to Purchase Common Stock (Right to buy) | $ 2.9 | 10/17/2011 | A(10) | 2,888 (13) | (10) | (10) | Common Stock | 2,888 | (10) | 2,888 (13) | D | ||||
Warrant to Purchase Common Stock (Right to buy) | (10) | (10) | (10) | Common Stock | 267,112 | 267,112 | I | See Footnote (14) | |||||||
Warrant to Purchase Common Stock (Right to buy) | (10) | (10) | (10) | Common Stock | 270,000 | 270,000 | I | See Footnote (15) | |||||||
Warrant to Purchase Common Stock (Right to buy) | (10) | (10) | (10) | Common Stock | 270,000 | 270,000 | I | See Footnote (16) | |||||||
Warrant to Purchase Common Stock (Right to buy) | (10) | (10) | (10) | Common Stock | 267,112 | 267,112 | I | See Footnote (17) | |||||||
Warrant to Purchase Common Stock (Right to buy) | (10) | (10) | (10) | Common Stock | 267,112 | 267,112 | I | See Footnote (18) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
NEW ATLANTIC VENTURE FUND III L P 11911 FREEDOM DRIVE SUITE 1080 RESTON, VA 20190 |
X | X | ||
NAV MANAGERS FUND LLC 11911 FREEDOM DRIVE SUITE 1080 RESTON, VA 20190 |
affiliate of Fund III | |||
NEW ATLANTIC ENTREPRENEUR FUND III LP 11911 FREEDOM DRIVE SUITE 1080 RESTON, VA 20190 |
affiliate of Fund III | |||
NEW ATLANTIC FUND III LLC 11911 FREEDOM DRIVE SUITE 1080 RESTON, VA 20190 |
X | |||
Backus John C 11911 FREEDOM DRIVE SUITE 1080 RESTON, VA 20190 |
X | |||
Hixon Todd L 11911 FREEDOM DRIVE SUITE 1080 RESTON, VA 20190 |
X | |||
Johnson Scott M 11911 FREEDOM DRIVE SUITE 1080 RESTON, VA 20190 |
X | |||
Delistathis Thanasis 11911 FREEDOM DRIVE SUITE 1080 RESTON, VA 20190 |
X |
New Atlantic Venture Fund III, L.P., By: New Atlantic Fund III, LLC (General Partner),By: /s/ John C. Backus, Title: Managing Member | 10/26/2011 | |
**Signature of Reporting Person | Date | |
NAV Managers Fund, LLC, By: /s/ Todd L. Hixon, Title: Member | 10/26/2011 | |
**Signature of Reporting Person | Date | |
New Atlantic Entrepreneur Fund III, L.P., By: New Atlantic Fund III, LLC (General Partner), By: /s/ John C. Backus, Title: Managing Member | 10/26/2011 | |
**Signature of Reporting Person | Date | |
New Atlantic Fund III, LLC, By: /s/ John C. Backus, Title: Managing Member | 10/26/2011 | |
**Signature of Reporting Person | Date | |
/s/ John C. Backus | 10/26/2011 | |
**Signature of Reporting Person | Date | |
/s/ Todd L. Hixon | 10/26/2011 | |
**Signature of Reporting Person | Date | |
/s/ Scott M. Johnson | 10/26/2011 | |
**Signature of Reporting Person | Date | |
/s/ Thanasis Delistathis | 10/26/2011 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | On October 17, 2011, New Atlantic Venture Fund III, L.P, a Delaware limited partnership ("Fund III"), New Atlantic Entrepreneur Fund, L.P., a Delaware limited partnership ("Entrepreneur Fund") and NAV Managers Fund, LLC, a Delaware limited liability company ("Managers Fund") acquired, in the aggregate, 10,000 shares of Series C Non Convertible Preferred Stock ("Preferred Stock") of the Issuer in a directly negotiated transaction at an aggregate purchase price of $1,000,000. Fund III purchased 9,539 shares of Preferred Stock of the Issuer, Entrepreneur Fund purchased 354 shares of Preferred Stock of the Issuer and Managers Fund purchased 107 shares of Preferred Stock of the Issuer. |
(2) | Represents shares owned directly by Fund III. |
(3) | Represents shares owned directly by Entrepreneur Fund. |
(4) | Represents shares owned directly by Managers Fund. |
(5) | Represents shares of Preferred Stock held indirectly by New Atlantic Fund III, LLC (the "General Partner"), the General Partner of Fund III and Entrepreneur Fund. |
(6) | Represents 9539 shares of Preferred Stock held indirectly by Mr. Backus in Fund III, 354 shares of Preferred Stock held indirectly by Mr. John Backus in Entrepreneur Fund, and 107 shares of Preferred Stock held indirectly by Mr. Backus in Managers Fund. |
(7) | Represents 9539 shares of Preferred Stock held indirectly by Mr. Hixon in Fund III, 354 shares of Preferred Stock held indirectly by Mr. Todd Hixon in Entrepreneur Fund, and 107 shares of Preferred Stock held indirectly by Mr. Hixon in Managers Fund. |
(8) | Represents 9539 shares of Preferred Stock held indirectly by Mr. Johnson in Fund III, and 354 shares of Preferred Stock held indirectly by Mr. Scott Johnson in Entrepreneur Fund. |
(9) | Represents 9539 shares of Preferred Stock held indirectly by Mr. Delistathis in Fund III, and 354 shares of Preferred Stock held indirectly by Mr. Thanasis Delistathis in Entrepreneur Fund. |
(10) | In connection with the Preferred Stock Purchase, on October 17, 2011, Fund III received an immediately exercisable 5-year warrant to purchase 257,544 shares of Issuer's Common Stock, Entrepreneur Fund received a warrant to purchase 9,568 shares of Issuer's Common Stock and Managers Fund received a warrant to purchase 2,888 shares of Issuer's Common Stock (collectively, the "Warrants"). Each warrant is exercisable at a price of $2.90 per share. |
(11) | Represents Warrants owned directly by Fund III. |
(12) | Represents Warrants owned directly by Entrepreneur Fund. |
(13) | Represents Warrants owned directly by Managers Fund. |
(14) | Represents warrants owned indirectly by the General Partner. |
(15) | Represents warrants owned indirectly by Mr. Backus. |
(16) | Represents warrants owned indirectly by Mr. Hixon. |
(17) | Represents warrants owned indirectly by Mr. Johnson. |
(18) | Represents warrants owned indirectly by Mr. Delistathis. |
Remarks: This is a joint filing by (i) Fund III, (ii) Managers Fund, an affiliate of Fund III which is member managed, (iii) Entrepreneur Fund, an affiliate of Fund III; (iv) New Atlantic Fund III, LLC which is the General Partner of Fund III and Entrepreneur Fund; (v) John C. Backus, a United States citizen ("Backus"), (vi) Todd L. Hixon ("Hixon"), a United States citizen, (vii) Scott M. Johnson ("Johnson"), a United States citizen and (viii) Thanasis Delistathis ("Delistathis"), a United States citizen. Messrs. Backus, Hixon, Johnson and Delistathis are the managing members of the General Partner. Mr. Hixon and Mr. Backus, as trustee of the John C. Backus, Jr. Irrevocable Trust, are members of Managers Fund. Messrs. Backus, Hixon, Johnson and Delistathis, share voting and investment control over all securities owned by Fund III, Entrepreneur Fund and the General Partner. The John C. Backus, Jr. Irrevocable Trust, John C. Backus, Trustee and Todd Hixon share voting and investment control over the securities owned by Managers Fund. Each of Messrs. Backus, Hixon, Johnson and Delistathis disclaim beneficial ownership of the shares held directly by Fund III, the General Partner and Entrepreneur Fund except to the extent of their pecuniary interest therein. Messrs. Backus and Hixon disclaim beneficial ownership of the shares held directly by Managers Fund, except to the extent of their pecuniary interest therein. The General Partner disclaims beneficial ownership of shares held directly by Fund III and Entrepreneur Fund except to the extent of its pecuniary interest therein. |